The Hidden Cost of Cancer in Singapore & How it Risks Your Savings

When we talk about cancer – a disease that affects thousands of Singaporeans¹ - the conversation often centres around the cost of medical treatment. However, it is the hidden costs of cancer often take patients and their families by surprise.

The hidden costs of cancer are the overlooked expenses that arise outside of direct cancer treatment. Examples include caregiving and loss of income, which can quietly drain savings. Being prepared for hidden costs is as important as managing the disease itself, so that the patient can focus on recovery.

In this article, we'll cover the prevalence of cancer in Singapore, cancer treatment cost in Singapore, and the hidden costs of cancer. We'll also share insights on how you can confidently navigate this overlooked aspect of cancer care.

Prevalence of cancer in Singapore

In Singapore, cancer remains a major health concern. The Singapore Cancer Registry 2021 Annual Report² notes that there were 84,002 cancer cases between 2017 to 2021, split almost evenly across males (49%) and females (51%). The report also notes an increasing trend of cancer being diagnosed later in life, with the median age being 66.4 years. 

There is a silver lining to these sobering statistics. Big leaps in cancer treatments and early screening mean that survival rates for cancer patients have greatly increased. These advancements offer hope and improved outcomes for patients and their families.

Total cancer treatment cost in Singapore 

There is no one-size-fits-all answer to the question, "How much does cancer treatment cost?" It depends on a combination of factors – the most important one being the type of cancer and stage at diagnosis. 

Early-stage cancer requires less intensive treatment, while advanced-stage cancers might require a combination of complex treatments. Additionally, aggressive or rare cancer types require specialized treatments, driving up the total cancer treatment cost.

The next factor is the treatment plan itself. Surgery can be expensive due to the need for specialist teams and a hospital stay, but it is often a one-time expense. Chemotherapy, on the other hand, involves recurring costs for the medicine over several cycles. Radiation therapy, while less invasive than surgery, requires sophisticated equipment and multiple sessions, leading to higher overall treatment costs.

Finally, choosing a public or private hospital matters, as private healthcare costs more. The type of ward also matters. Private suites in public and private hospitals come with a higher price tag but offer more comfort and privacy. Conversely, subsidised wards in public hospitals are cost-effective but typically have less privacy.

Average cost of cancer surgery in Singapore

Here are some rough benchmarks for cancer surgery costs from the Ministry of Health. These costs are accurate as of 15 Nov 2023. Note that your final hospital bill will depend on the severity of the cancer, the length of stay, and the person’s overall condition.

Average cost of chemotherapy in Singapore

Chemotherapy prices in Singapore depend on the type and stage of cancer at diagnosis, the specific drugs used, and the number of cycles. 

The National University Cancer Institute Singapore (NCIS) has a rough benchmark of chemotherapy costs, excluding consultation fees, cost of laboratory investigations and scans⁷. Note that this is just a reference, and the actual costs can vary based on the individual's condition and chemotherapy regimen.

7 hidden costs of cancer in Singapore   

Beyond the costs of chemotherapy or surgery, patients often face hidden expenses that add stress to their recovery. Here are some unexpected costs that could arise during the battle against cancer. 

Screenings and blood tests

Screenings and blood tests are required frequently over a long period of time, which drives up the overall cost throughout a person's cancer journey. 

From the moment you see a specialist, you'll need a series of tests to arrive at an accurate diagnosis and appropriate treatment plan. As the treatment goes on, regular screenings like mammograms or blood tests are done to monitor the response and to check for any signs of recurrence.

Cancer rehabilitation

After the primary cancer treatment, patients may need extra care and support to manage side effects and improve their quality of life. These are known as cancer rehabilitation or post-treatment care, and can include modalities like physical therapy, acupuncture, or psychological support.

While important for recovery and maintaining health, post-treatment care can be expensive and often fall outside of insurance coverage. Therefore it is important to have a complete financial plan that covers not just the treatment costs, but the recovery costs too.

Loss of income

When you think of cancer costs, loss of income doesn't usually come to mind. Taking leave for treatment or medical appointment is normally not an issue for employees with paid hospital leave. When recovery takes longer than anticipated, however, employees risk taking unpaid leave, impacting their income.

For gig and platform workers, cancer's financial impact is more serious. Besides lacking paid medical leave, 60% of gig workers are not covered by employer's insurance⁸.  This means gig workers risk having zero income while recovering from treatment, and may need to pay out-of-pocket for treatment.

Caregiving costs

Cancer patients need additional help with daily activities. When family members cannot help, you can hire professional caregivers or private nurses. A certified caregiver's cost per hour can start at $21⁹, and adds up significantly if 24-hour care is needed.

Family members who step in as caregivers also face indirect costs, such as taking unpaid leave from work.

Impact on household expenses

Cancer can significantly impact a household's expenses, often in ways that aren't immediately apparent. There might be higher utility bills due to more time spent at home during recovery, or additional expenses for special diets or supplements. Transportation costs can also rise with frequent trips to medical appointments. 

For families, the need for additional childcare, elder care, or a domestic helper can arise if the parent recovering from cancer is also the primary caregiver.

Impact on long-term financial goals

Cancer can impact long-term financial goals. Insufficient insurance coverage can deplete savings and necessitate dipping into retirement savings. Additionally, the need to prioritise immediate healthcare expenses can lead to a halt or reduction in regular contributions to long-term savings.

As a result, individuals battling cancer might face a delayed retirement or a change in the quality of life, as the nest egg they have been building for years get diminished by unforeseen medical expenses. 

This scenario highlights the importance of being prepared for health emergencies to protect long-term financial stability. 

Hospice care

Hospice care or palliative care often represents a hidden cost that many don't anticipate. This specialised care, centred on providing comfort and support rather than treatment, becomes necessary when a cancer patient is in the last weeks of their life.   

The costs depend on the type of hospice care. Inpatient care – usually recommended for those with conditions that families cannot care for – is  estimated to cost $7,000 per month¹⁰. Home hospice care is provided for free by charities like Hospice Care Association¹¹; however, you may still need to spend on items like pain medication. 

5 steps you can take to reduce the risk of cancer and protect your savings

When we think about reducing the risk of cancer, we usually focus on how to stay healthy. While  this can significantly lower the risk of cancer, it's equally important to safeguard your financial health in case the disease strikes unexpectedly. 

Here's what you can do to reduce the risk of cancer and protect your wealth:

Get regular health screenings

Regular screenings are important for two key reasons: early detection and financial protection.   

By getting screened regularly, doctors can detect pre-cancerous conditions or early stages of cancer that may not show symptoms. At the initial stages, cancer is far easier to treat and is more likely to show successful outcomes. On the other hand, late-stage cancer treatments are typically more complex and expensive.

Ask your doctor how often you should get health screenings based on your age, health, and family history of cancer.

Build an emergency fund

An emergency fund is the foundation of any financial plan. In the unfortunate event of an illness, this serves as a safety net for managing costs like co-payments, cancer test fees, and other costs that are not covered by health insurance. 

Useful as emergency savings might be, they can be limited in the battle against cancer. Treatments like radiotherapy and immunotherapy involve substantial costs that can quickly exceed the typical emergency savings (usually 6 months of your income).  

Even if your hospital insurance can cover these therapies, recovering from treatment side effects can take several months. You might need to take time off from work, and the average emergency fund may not be enough to cover living expenses for this period.

Consider critical illness insurance

Having emergency savings is a great start, but having a critical illness insurance (CI) plan can give you more robust financial protection against critical illness like cancer.

If the emergency fund is a safety net for unexpected expenses, CI insurance plan is an even bigger net that cushions you from financial hardship. In the event of a cancer diagnosis, you receive a lump sum payout according to the terms of the plan. You can use this to pay for the expenses that health insurance or emergency savings might not fully cover, such as hiring a domestic helper or paying for post-cancer care.

In short, adding CI insurance plan to your overall financial portfolio makes your financial safety net much stronger against the costs of dealing with cancer.

Evaluate your existing insurance plans for protection gaps

Having a CI insurance plan is a good starting point, but it needs to cover all your financial commitments in case of a lengthy recovery period. Otherwise, you may be vulnerable to a protection gap – the shortfall between your financial resources (including cash and insurance) and the real costs of battling cancer for a period of 5 years¹².

You can check your existing insurance plans for any protection gap by doing the following steps. Alternatively, you can consult your financial consultant and go through these steps together:

• Estimate your financial commitments per year for 5 years. This includes things like household expenses, mortgage, university costs, childcare or eldercare.   
• Estimate the rough cost of cancer treatments. The prices we outlined above are a good starting point as reference, however the actual costs depend on the type of cancer and the stage.
• Assess your current CI or health insurance coverage. Check the lump sum amount or coverage amount and understand what's excluded.
• Calculate the shortfall. Your protection gap is the difference between your estimated financial needs and the amount you're covered by insurance. 

Protect yourself from cancer's hidden costs today

Being proactive is your best defence against cancer's financial impact. Besides living a healthy lifestyle, going for regular health screenings and financial health check-up can help you understand your current position and identify any gaps in your coverage. 

Consult with a financial consultant to gain insights and guidance on tailoring your insurance and savings plans to ensure you are fully prepared. Remember, the earlier you take these steps, the better equipped you'll be to handle the financial challenges that a cancer diagnosis may bring. 

Footnotes

1. https://www.nccs.com.sg/patient-care/cancer-types/cancer-statistics
2. https://www.nrdo.gov.sg/docs/librariesprovider3/default-document-library/scr-ar-2021-web-report.pdf?sfvrsn=591fc02c_0
3. https://www.moh.gov.sg/cost-financing/hospital-bills-and-fee-benchmarks-search-result/detail?Code=SA707B--1&HasSurgicalProcedure=true
4. https://www.moh.gov.sg/cost-financing/hospital-bills-and-fee-benchmarks-search-result/detail?Code=E71B--0&HasSurgicalProcedure=false
5. https://www.moh.gov.sg/cost-financing/hospital-bills-and-fee-benchmarks-search-result/detail?Code=R61B--0&HasSurgicalProcedure=false
6. https://www.moh.gov.sg/cost-financing/hospital-bills-and-fee-benchmarks-search-result/detail?Code=R62B--0&HasSurgicalProcedure=false
7. https://www.ncis.com.sg/For-Patients-and-Visitors/Pages/Chemotherapy-Bill-Estimates.aspx
8. https://www.lia.org.sg/media/3974/lia-pgs-2022-report_final_8-sep-2023.pdf, page 54
9. https://www.homage.sg/services/cancer-care/
10. https://www.healthhub.sg/live-healthy/inpatienthospicecareaic
11. https://www.hca.org.sg/who-we-are/
12. Life Insurance Association Singapore's definition of CI protection gap https://www.lia.org.sg/media/3972/lia-pgs-2022-press-release_final_8-sep-2023.pdf

Important Notes

The products are underwritten by Manulife (Singapore) Pte. Ltd. (Reg. No. 19802116D). This advertisement has not been reviewed by the Monetary Authority of Singapore. Buying health insurance products that are unsuitable for you may affect your ability to finance your future healthcare needs. This material is for your information only and does not consider your specific investment objectives, financial situation or needs. It is not a contract of insurance and is not intended as an offer or recommendation to purchase the plan. You can find the full terms and conditions, details, and exclusions for the mentioned insurance product(s) in the policy contract. If there are any differences between the English and Chinese versions of this material, the English version will apply. This policy is protected under the Policy Owners' Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benefits that are covered under the scheme as well as the limits of coverage, where applicable, please contact us or visit the LIA or SDIC websites (www.lia.org.sg or www.sdic.org.sg).

We recommend that you seek advice from a Manulife Financial Consultant or our Appointed Distributors before making a commitment to purchase a policy.

Information is correct as at 20 Feb 2024.